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9 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Anaplastic thyroid cancer is the rare, fast-growing form that presents as a rapidly enlarging neck mass threatening the airway. Few patients lived more than a few months; combining BRAF-targeted drugs, immunotherapy, surgery and radiotherapy has lifted survival for the first time.
Anaplastic thyroid cancer is an undifferentiated carcinoma that usually arises from a pre-existing papillary or follicular cancer through the accumulation of TP53 and TERT mutations; about 40 percent carry BRAF V600E. It presents in older adults as a hard, rapidly growing neck mass with hoarseness, breathing or swallowing difficulty, and it does not take up iodine. Every case is staged IV. Rapid molecular testing is now urged at diagnosis because BRAF V600E tumours respond to dabrafenib plus trametinib, approved in 2018 on the ROAR basket trial, and neoadjuvant use has made some inoperable tumours resectable; pembrolizumab added to targeted therapy and chemoradiation for resectable disease are part of the multimodal approach that raised one-year survival at MD Anderson from about a fifth to over half. Airway management and early palliative care remain central.
| Setting | Approach | Guideline |
|---|---|---|
| Diagnosis | Core biopsy with rapid BRAF testing, airway assessment, staging CT and PET; multidisciplinary planning within days. | not mapped |
| BRAF V600E-mutant | Dabrafenib plus trametinib, with pembrolizumab in many centres; neoadjuvant use to make tumours resectable, then surgery and radiotherapy. | not mapped |
| BRAF wild-type, resectable | Surgery followed by chemoradiation (paclitaxel- or doxorubicin-based). | not mapped |
| Unresectable BRAF wild-type | Chemoradiation or immunotherapy in trials; lenvatinib in some countries; palliative radiotherapy and airway support. | not mapped |